高渗氯化钠羟乙基淀粉40注射液对全身高温大鼠脑组织病理学的影响

Effects of hypertonic sodium chloride hydroxyethyl starch 40 on brain histopathology in rats with whole body hyperthermia

目的观察高渗氯化钠羟乙基淀粉40注射液对全身高温大鼠脑水肿和脑组织细胞形态学的影响。方法成年雄性SD大鼠60只,随机分为5组:正常对照组(C组)、高温不输液组(HT组)、高温林格组(RL组)、高温羟乙基淀粉林格组(HRL组)和高温高渗氯化钠羟乙基淀粉40注射液(HSH组)。C组大鼠置于(22±1)℃的环境中4 h,其余4组大鼠置于36℃具备生物氧供给的加温舱中加温3 h达肛温41～42℃,加温开始30 min内根据实验分组情况输入相应的液体,3 h后出舱,在室温下降温1 h,加温期间监测肛温、平均动脉压(MAP)。采用干湿法检测脑组织百分含水量,光镜和电镜下观察脑组织细胞形态学。结果各高温实验组脑水百分含量均显著高于C组(P<0.05或0.01),HSH组脑水百分含量显著低于HT组(P<0.05)。光镜下HSH组脑组织轻度水肿,多数细胞结构基本正常;HT组、RL组和HRL组出现重中度水肿和细胞损害改变。电镜下HT组大鼠神经元胞体水肿严重,胞质变空,核皱缩;RL组和HRL组神经元也出现不同程度损害改变;而HSH组神经元改变轻微。结论高晶胶体液高渗氯化钠羟乙基淀粉40注射液能减轻全身高温大鼠脑水肿和脑细胞损害的程度。

Objective To investigate the effects of hypertonic sodium chloride hydroxyethyl starch 40（HSH） on brain edema and morphological changes during whole body hyperthermia（WBH） in rats.Methods Sixty adult male SD rats were randomized into control group,WBH group without fluid infusion（group HT）,WBH group with Ringer＇s infusion（group RL）,WBH group with HAES ＋ Ringer＇s infusion（group HRL） and WBH group with HSH infusion（group HSH）.WBH was induced by exposure to 36 ℃ for 3 h to achieve a rectal temperature of 41-42 ℃,and the corresponding fluids were administered intravenously within 30 min at the beginning of WBH.The control rats were housed at a controlled room temperature（22±1） ℃ for 4 h.After cooling at room temperature for 1 h,the rats were sacrificed and brain water content and morphological changes were evaluated.Results Compared with the control group,all the WBH groups had significantly increased brain water content（P0.05 or 0.01）,but group HSH showed a significantly lower brain water content than group HT（P0.05）.The rats in groups HT,RL and HRL showed serious to moderate structural changes of the brain tissue and nerve cells,but HSH group had only mild pathologies.Conclusion HSH can reduce brain edema and ameliorate the damages to brain cells in rats exposed to WBH.